Nursery want DS to see Psychologist

[Riverblu]

Hi Everyone

First time posting looking for some advice. My DS is 4 and attends nursery.

When DS started nursery i was aware my DS was not as on Par at speaking his words as clear as some of the other children as some of his words were great and some words in his speaking sounded gobbledygook lol. His nursery keyworker asked if i would allow DS to see a speech and language therapist and of course i agreed, anyway i took DS to his appointment with the speech and language therapist and she sat with DS showed him pictures and asked him to tell her what they were and what he seen in the pictures which he did and then he say and played with some toys chatting to him and he responded well to her. She said in terms of his language he is slightly behind but not greatly and suggested some activities they can give to encourage his language bearing in mind this all happened just before covid, so activities were sent out to home and i did the activities with DS and DS loved doing them and telling me what to do when it was my turn. The speech and language therapist stayed in contact to see how things were going and i felt he was dping really well she explained that she didnt feel DS needed therapy as DS was one of the best on her books. She said she would try get into nursery to observe how DS is in nursery but covid came and stopped that anyways iv always continued the activities and nursery activities and others commented on how clear he was becoming with speaking. When DS returned to nirsery after the 6-7 months lockdown obviously kids where excited to be back seeing friends and new children started. Last week DS keyworker in nursery grabbed me for a quick chat and mentioned how DS will come and sit at grouptime but looks around to to see what others are doing and appears to not be listening and easily distracted with attention. Now im thinking all kids can be known for the same and she mentioned when playing with another child they laugh , get overly excited and sometimes scream or jump when having a good old time. At home i must make it clear DS is not hyper, ants in pants over excited pr anything like that. DS will happily sit on the floor doing jigsaws lining up his cars on the race track, watch a movie or cartoons and play on his ipad with some games (educational). So i know DS doesnt have an issue of being able to sit and concentrate on things i find instead when something isnt of interest DS will lose attention.i feel at nursery DS is just happy to be there and loves being with friends but the keyworker is now suggesting a referral to psychological Services for an assessment to see what they think and maybe get DS support in school for listening and attention to keep DS on track which yes i agreed to asmi wasntrying to process this. Its being playing on my mind since and now i feel DS no matter what he does is getting scrutinised for it its described as like i have DS at home one way and put a different child into nursery. I would love to know what anyone else thinks am i being sensitive or is there something not quite right ?

Having had a child with ASC and ADHD ime schools and nurseries tend to downplay issues rather than make something out of nothing. My son didn't get assessed until secondary school despite numerous problems at home and in a nursery/school setting which I am was constantly told were normal and he would outgrow. I now know lots of special needs mums and this is a common experience.

I therefore think it's highly unlikely that there are no behaviours of concern but as others have said if he gets an assessment and nothing is "wrong" they will tell you this. If there is something going on your son will get support at an earth age which is fantastic and will really help him have a several and happy school experience.

I don't see any negatives in this at all.

Riverblu try not to read too much into any comments on here, other than the ones saying that it's great that nursery are pushing to get your son assessed now.

Educational psychologists aren't there to judge or label children. They're there to assess whether a child has a particular learning need that can be helped with or if there is anything impeding on their development.

Assessments and tests sound scary and as though your child might 'pass' or 'fail'. They're not like that - they're to get a detailed picture of how your child is doing in a range of things compared to other children of his age. Some children can be way 'ahead' is an average for eg 4 years old in some areas, and 'behind' in others.

Identifying anything that is 'behind', reasons for it and what will support them will help any child.

gottakeeponmoving something very similar happened to a child in one of my children's classes. It was obvious to everyone that she was struggling socially and in a school environment. Her parents were in absolute denial. The school put lots of things in place to support her, though there were daily problems with her 'getting into trouble'. Other children were also scared of her behaviour.

The parents decided to move her school as they thought the school was the problem. At the same time, they agreed to finally to go ahead with an Ed Psych assessment.

Turned out that she is autistic and with the right support in place has been managing pretty well at her new school.

I’m wondering if what @MaryLeeOnHigh has picked up on what I did. I strongly believe my Ds is autistic (and I’m not saying at all this is what your son has). He used to line his trains up in a certain way each time and also spent a lot of time doing jigsaws, the same jigsaw, in the same way each time. Reading your post, your Ds reminded me a lot of my Ds. We have never tried to get a Diagnosis for Ds, he manages perfectly well With life without one, but has all the classic symptoms.

I would be extremely grateful to your nursery for pushing for support for your Ds though. We have been asking for help for dd for Over 4 years and have only got Help for her this summer. It has been an horrendous time for us as a family and if I could give you any advice it would be to take every bit of support you are offered because it might be years before you get offered any more.

Hopefully your son will be assessed and they will find no issues, but at least you will know.

Definitely go ahead with referral, as has been suggested already, it can take months anyway to get seen.

We have the opposite problem with DS. He doesn't listen and is inattentive at home, yet appears to be fine in nursery setting. We still have concerns and paediatrician has said he can do CAMHS referral but we are talking months here before he will eventually be seen. Also "Play is the Way" is the strategy used in nurseries so they are encouraged to be busy, making it incredibly difficult for staff to see same issues we see in DS. SALT found DS inattentive at adult led activities for her assessment too. DS has a speech disorder and a speech delay. 5yo and delayed start to P1.

It sounds like you are making great progress with the homework SALT gave you.

I do agree with a few other posters though that nursery staff are seeing a huge range of children day in and day out and will have a rough idea of what they are concerned about with each child. It's always best to get stuff picked up sooner rather than later.

@Riverblu I'm in the exact same position as you with 3yo DS, I could have written your post. I'm grateful for the referrals to get help in place for DS before he starts school but I feel a bit frustrated/clueless as to what it could potentially be?

This could be written about my son too! Nursery have told me they’re concerned about the transition from their setting to school as DS also struggles with concentrating in large groups. I had a meeting with the complex needs team and after talking about his progress over the last year we decided that applying for an inclusion grant rather than an EHCP.

We also have no diagnosis. He had a speech delay, but has now been discharged. We had a paediatric assessment for autism and he was discharged.

@BitchIAmFromChicago what does the inclusion grant do? I've not heard of it before.

Inclusion fund usually goes towards things like extra staffing, equipment, staff training. It's not a huge amount though, about £1000 a term where I am, so if a child needs 1:1 support it is used up very quickly.

As someone who's worked in nurseries as well as the HV service I'd go back to the nursery and ask them to outline exactly what their concerns are. I'd say, I know you aren't qualified to say, but what are you thinking, please be honest with me.

The amount of children I'd think 'yep, ASD' have to beat around the bush with parents to get consent for a referral without worrying them with the 'A' word was shameful. It was a mix of I KNOW I'm not qualified to diagnose, I know this child needs an EP and paeds for further assessment, equally, I'm experienced enough to know ASD a mile off when I see it... I was never once wrong.

Just be open with them, see if they will be with you. Say you'd rather know what they're thinking so you're all on the same page. If any parent had said that to me I'd have said 'I'm not qualified to diagnose, but I think he may have some additional social and communication needs' for example.
Hope this helps/gives you some insight into nursery's position.

You've had some excellent replies on this thread OP. Absolutely spot on.
It takes quite a high barrier to make a referral to an EP. Nursery staff know they have to be very careful with the way they phrase things to parents. No, they can't diagnose anything (nor can EPs) but they have the experience of working with a wide range of children with different strengths and different difficulties, and they will see when there is something that needs some further professional advice.
As has been said, children can behave very differently when they are 1:1 at home from the way they cope in a busy, noisy environment filled with lots of other unpredictable small humans.

Just let them help as much as possible. It might be something fixed easily or with meds. I remember being referred to a psychologist via school - they totally missed my dyslexia and dyspraxia (that was diagnosed in adulthood and I was able to mask) but caught something else that was treated and which made sitting painful.

I also agree with other pp's that to refer to an EP I would have to have significant concerns about a child. Something doesn't quite add up. You don't seem concerned, nursery do.

@xmasnc2020 what do you think the signs could be for ASD?

I've always had a sense that DS wasn't meeting milestones and had SALT issues. I kept being fobbed off but we changed nurseries and they have been brilliant at referring him and pushing for support. I know they can't diagnose but I have no idea what they are considering as a potential diagnosis so I fret about the unknown.

OP sorry for jumping in on your thread. Have they said how long a referral will take?

@Twilightstarbright it took a year to get our ADOS appointment.

@Twilightstarbright not at all hun im glad you are asking. His keyworker reckons it could be maybe Feb before any assessment and even at that it will probably be via zoom because of Covid so who knows im same as you just fretting and worrying about it all xx

@Twilightstarbright it's so hard to say over the internet with 0 information about you child.

You may have heard the phrase 'if you've met one person with autism... you've met one person with autism' and that sums it up. All children with autism are so different, they present differently. It's such a wide spectrum, I would never be able to say.

General things could be:
Delay in speech and language development

Sensory issues, things like them being 'funny' with food textures and tastes. Not liking the feeling of certain things, wet, gooey, dry, sandy etc.

Lack of social communication, so lack of eye contact, not responding to their own name, not responding when spoken to, not being able to have a 'normal' back and forth conversation, maybe acting in appropriately or not getting or understanding normal social cues.

Maybe being hypo sensitive to things and climbing repetitively, jumping, spinning to try to feel more of the sensation. Also, flapping hands, tapping body parts, clapping, any repetitive movements. Any way that they can seek a sensory experience, tipping toys out of baskets to make a big crash, repetitively throwing things to bang on the floor etc.

Any other repetitive behaviours, lining things up (this is also typical child development, but is it more than that? Do they line things up ALL the time, do they get upset when you try to stop them?) Do they have a big obsession with doing one specific thing all the time?

Or they could be the complete opposite and be hyper sensitive to things, they may be completely overwhelmed by day to day life and want to be in an enclosed space, think in a den, under a table etc.

This is a VERY general description of things that may concern me in the early years, there are 1000 more things I could type. But also, it's not just how they are on paper, I can see it within 5 minutes of meeting a child, with experience you just 'know.' I think to sum it up, it would be to describe a child as 'being in their own little world' which you hear all the time, but this is not all children with autism, just some.

Good luck to both of you, it can be a tricky process. I hope your children get the support, if they need it.

Thank you that's really helpful.

@Riverblu easier said than done I know but I'm trying not to worry and see it as a positive that his caregivers are keen to get him the support he potentially needs.

We are seeing the peadiatrian from the child development service next week and will see what they say.